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Disclosures: The authors report no relevant financial disclosures.
August 28, 2020
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Less than 1% of asymptomatic children test positive for SARS-CoV-2 in US hospitals

Disclosures: The authors report no relevant financial disclosures.
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Results showed that less than 1% of asymptomatic children routinely tested for SARS-CoV-2 at more than two dozen children’s hospitals in the United States were positive for the coronavirus.

Dylan K. Chan

The tests were conducted this past spring as the hospitals resumed elective medical and surgical care, according to Dylan K. Chan, MD, PhD, an associate professor of otolaryngology at the University of California, San Francisco, and colleagues.

According to the researchers, 250 of the 33,041 asymptomatic children tested for SARS-CoV-2 at the 28 children’s hospitals through May 29 were positive for the virus. The prevalence in the 25 communities served by these hospitals was similar and varied from 0% to 2.2%, with a pooled prevalence of 0.65% (95% CI, 0.47-0.83%).

All incidence rates were calculated using the Johns Hopkins University confirmed cases database.

“Clinicians can expect the rate of SARS-CoV-2 infections among asymptomatic children in their care to be somewhere around 0.65%, but the actual rate will vary quite a bit from place to place,” Chan told Healio. “Our finding that this asymptomatic prevalence can be estimated directly from the Johns Hopkins database allows clinicians to estimate their asymptomatic pediatric prevalence for their own local populations. They can use this information, then, to help guide their practices in terms of routine COVID-19 testing for their patients, and [personal protective equipment] use and infection control policies for their practices.”

According to Chan, the researchers have developed an online tool that will allow individuals to calculate risk factors in regard to prevalence in any county in the country. He said that schools can use this tool to estimate risks within the classroom.

Chan noted that a positive test will not indicate how infectious a child is — a critical component in understanding the risk for transmission and outbreaks, for which more research is required.